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50th Anniversary Report on Smoking and Health

Fifty years after the first report, the 2014 Surgeon General’s Report on Smoking and Health reveals new details about the dangers of smoking as well as strategies to curtail the tobacco use epidemic.

Did you think that you already knew everything there was to know about how tobacco smoking affects health? Think again. A new Surgeon General’s Report (SGR) on smoking and health—The Health Consequences of Smoking: 50 Years of Progress—offers startling new details about the dangers of smoking as well as strategies to curtail the tobacco use epidemic that still sickens and kills many Americans. The 2014 report comes out 50 years after the first SGR on smoking was released—a time when about 4 in 10 Americans smoked.

In the early 1960s, tobacco use was the norm. People smoked in restaurants, airplanes, office buildings—even in hospitals. And tobacco marketing was everywhere. The Marlboro Man appeared in magazines and newspapers, children "smoked" candy cigarettes, and tobacco companies sponsored sports events and concerts. Doctors joined in, claiming that some cigarette brands were "safe" and less irritating. Even children's cartoon characters, such as the Flintstones, peddled cigarettes on TV commercials.

Then on January 11, 1964, U.S. Surgeon General, Dr. Luther Terry released the first report on smoking and health—a landmark federal document report linking smoking to lung cancer and heart disease in men. This scientifically rigorous report laid the foundation for tobacco prevention and control efforts in the United States.

50 Years of Research and Progress in Tobacco Prevention and Control

Since 1964, 31 more SGR reports have documented the harmful effects of tobacco use, such as the dangers of secondhand smoke (1986 and 2006), the impact of smoking on minority populations (1998 and 2001), and how to prevent tobacco use by youth and young adults (1994 and 2012). We now know that smoking causes 13 types of cancer and many other illnesses. Smoking is linked to diseases of nearly every organ in the body.

Successes and Challenges in Tobacco Prevention and Control

The good news is that:

Fewer than 20% of Americans now smoke, compared with 42% in 1964. This success is due to comprehensive tobacco control efforts over the last 50 years.

Tobacco advertising has been banned from TV and radio in the United States.

Twenty-six states and the District of Columbia have enacted laws prohibiting smoking in all indoor areas of worksites and public places, including bars and restaurants.

The bad news is that smoking remains the leading preventable cause of disease and death in the United States, killing about 480,000 Americans a year and costing nearly $280 billion a year in health care costs and lost productivity.

Highlights of the 2014 Surgeon General's Report on Smoking and Health

The 50th anniversary SGR expands our knowledge of the dangers of smoking even further. The report updates the human and financial tolls caused by cigarette smoking, with disturbing findings:

20 million people have died since 1964 from smoking-related illnesses. Most deaths have been among adults with a history of smoking; however, 2.5 million nonsmokers died from diseases caused by exposure to secondhand smoke.

The list of illnesses caused by smoking has grown and now includes diabetes, colorectal cancer, and liver cancer. Smoking is also now known to be a cause of rheumatoid arthritis and increase the risk for tuberculosis (TB) and death from TB. Smoking raises the risk for impaired fertility, ectopic pregnancy, and cleft lip and cleft palate (birth defects) in babies of women who smoke during early pregnancy. Smoking is linked to erectile dysfunction (impotence) and age-related macular degeneration, which is a condition affecting eyesight. Smoking also interferes with cancer treatment. And finally, the report indicates that secondhand smoke exposure causes strokes in nonsmokers.

Smokers today have a greater risk of developing lung cancer than they did in 1964, even though they smoke fewer cigarettes. Changes in the design and composition of cigarettes may contribute to this increase in risk. At least 70 of the chemicals and chemical compounds in cigarette smoke are known to cause cancer.

For the first time, women are as likely as men to die from many of the diseases caused by smoking. These include lung cancer, chronic obstructive pulmonary disease (COPD), and heart disease.

Cigarette smoking makes people less healthy, harms immune function, and reduces quality of life.

5.6 million children alive today will die early from smoking unless we take steps to stop the tobacco epidemic. See how many children (ages 0-17) are at risk in your state

The Future of Tobacco Control

The 2014 report makes clear that smoking is deadly for everyone. As Acting Surgeon General Boris Lushniak stated, "Despite 50 years of steady progress in reducing smoking rates, this nation continues to pay a heavy price in both lives and resources because of tobacco use. Without immediate and dramatic action to end the tobacco-use epidemic, the disease and death caused by smoking will continue at unacceptably high rates well into this century."

During the past 50 years, progress in tobacco control has validated specific strategies that work well to reduce tobacco use. These include:

Affordable and accessible cessation help for all smokers who want to quit

A top priority discussed in the new report calls for an end to the use of cigarettes, which is the major cause of tobacco-related disease and death.

If proven strategies are implemented at the local, state, and federal levels, public health leaders are confident we can reach a point where tobacco use is rare rather than an epidemic. This achievable goal has the potential to save millions of Americans from preventable disease and death.